Yes, I know this is old, but still I would appreciate any information
concerning cotinine content in breastmilk, particularly information that
I can freely quote, or web-based, just point me in the right direction.
Thanks -- Dee.  Louisville, Kentucky

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Researchers led by Dr. Maria A. Mascola of Massachusetts General
Hospital in Boston compared levels of cotinine -- a byproduct of
nicotine metabolism -- in the urine of 330 breast-fed and bottle-fed
babies whose mothers smoked. The breast-fed babies had cotinine levels
10 times higher than the bottle-fed infants, the researchers reported.

These findings are significant because exposure to chemicals in tobacco
smoke during infancy has been linked to higher risks of asthma, sudden
infant death syndrome, and infant death due to other causes.

Mascola and her colleagues also compared levels of cotinine in urine
samples from breast-fed babies whose mothers smoked in the same room as
their infants, and breast-fed babies whose mothers usually smoked in
different rooms. They found no significant differences in urine cotinine
levels between the two groups of infants.

The study findings also suggest that nursing babies whose mothers smoke
are exposed to considerably more nicotine via breast milk than via
environmental or ``second-hand'' smoke, the researchers wrote.

``It is possible that adverse health consequences in children previously
attributed only to environmental tobacco smoke exposure by inhalation
may also result from exposure to both environmental tobacco smoke and
the breast milk of smoking mothers,'' they noted.

``Healthcare providers need to be as diligent in encouraging mothers to
stop smoking after birth as in the prenatal period, especially those
mothers who intend to breastfeed,'' they concluded, ``and those mothers
unable to stop smoking should be informed of the possibility that
harmful chemicals derived from tobacco smoke may be transmitted to their
infants via breast milk.''

SOURCE: American Journal of Public Health 1998;88:893-896.

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